Smaller and critical access hospitals face additional barriers to fully implementing electronic health records and achieving meaningful use than larger and urban and suburban facilities. In addition to the struggles with physician engagement, finding user-friendly software and maintaining workflow and efficiency during the transition, these hospitals also face struggles with distance, isolation and limited funds.
"The additional barriers faced by smaller hospitals are very real," says Mat Kendall, director of the office of provider adoption support in the Office of the National Coordinator for Health Information Technology.
"And the challenges are different in a smaller hospital than in a larger one," he says. For example, these hospitals often have restricted access to the necessary capital to launch an EHR system, or the hospital's location may mean trained technical personnel are not as accessible.
"We encourage folks to begin by developing a good work plan and establishing goals," for the new system, says Mr. Kendall. "Because it can sometimes be difficult for small hospitals to justify a single funding outlay for a new [EHR] system, it's important to recognize the benefits of health IT in these settings."
These benefits include instant access to information providers need to make timely decisions, the ability to engage offsite providers in remote consults, decreased travel time for patients and their families and easier transfer of patients to tertiary facilities for specialized care.
To help facilitate EHR adoption, ONC has funded 62 Regional Extension Centers across the country to facilitate EHR adoption among individual and small physician practices, as well as critical access hospitals, federally qualified health centers and other facilities that provide care for underserved populations.
"Funded directly from the HITECH provisions in the American Recovery and Reinvestment Act, these centers help smaller providers across the country" implement and maintain EHRs, says Mr. Kendall. Currently, 1,164 critical access and other smaller hospitals are working with a REC, according to a recent report issued by ONC. Of these hospitals, 48 percent are using an EHR system, and 41 percent of those have achieved meaningful use, according to the report. "Our goal is to help everyone to meaningful use," says Mr. Kendall. Considering the challenges and the relative newness of the RECs, "we've had a lot of success," he says.
ONC has online resources as well to help smaller hospitals adopt EHRs and achieve meaningful use. They can he found here.
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